A randomized, double-blind study on the efficacy of oral domperidone versus placebo for reducing SARS-CoV-2 viral load in mild-to-moderate COVID-19 patients in primary health care.

INTRODUCTION: The clinical effect of domperidone against COVID-19 has been investigated in a double-blind phase III clinical trial (EudraCT number 2021-001228-17). Domperidone has shown in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and potential immudolatory properties through the stimulation of prolactin secretion. PATIENTS AND METHODS: The efficacy of oral domperidone plus standard of care (SOC; n = 87) versus placebo plus SOC (n = 86) was evaluated in a 28-day randomized double-blind multicentre study in primary health care centres. A total of 173 outpatients with mild-to-moderate COVID-19 were included. Three daily doses of 10 mg (30 mg/day) of domperidone or placebo were administered for 7 days. Reduction of viral load on day 4 was the primary efficay endpoint. It was estimated in saliva samples by reverse transcription-quantitative polymerase chain reaction (RT-qPCR), as the cycle thresholds detected ORF1ab, N Protein and S Protein genes. RESULTS: A significant reduction in the viral load was observed (p < 0.001) from baseline to days 4, 7 and 14 of the three genes studied with non-significant differences between domperidone and placebo groups. Twenty-three patients (13.3%) experienced adverse events, 14 patients in the domperidone group (16.1%) and 9 patients in the placebo group (10.5%). No patients needed to be hospitalized. CONCLUSION: Results do not prove the use of domperidone as antiviral in patients with COVID-19.

A 28-day double-blind clinical trial was performed to investigate the antiviral effect of domperidone, 30 mg/day for 7 days (n = 87) versus placebo (n = 86) in outpatients with mild-to-moderate COVID-19.The primary efficacy endpoint was the reduction of viral load on day 4 as compared with baseline, estimated as the cycle thresholds to detect ORF1ab, N Protein and S Protein genes by RT-qPCR in saliva samples.The study findings do not prove the use of domperidone as antiviral in patients with COVID-19.

[Do our patients know what a family medicine resident is?]. / Saben nuestros pacientes qué es un residente de medicina de familia?

OBJECTIVES: To find patients' view of the idea of family and community medicine (FCM) residents and of what they do and patients' satisfaction with their work. DESIGN: Cross-sectional, descriptive study using a questionnaire. SETTING: FCM teaching health centres. Area 7, Madrid, Spain. PARTICIPANTS: Twenty-one tutors' lists, with 220 people. MAIN MEASUREMENTS: Social and demographic variables, concept of FCM resident, satisfaction with resident, comparisons between resident and tutor, changes observed by patients in their doctor. RESULTS: Women patients numbered 146 (66.4%); average age, 56.2 (18.95); 138 (62.7%) did not know exactly what a resident was, although 132 (60%) said he/she was a doctor. Knowledge increased with greater educational level (P< .001) and younger age (P=.04). Eighty-five (38.6%) demanded more from the tutor and tolerated errors of both equally; 196 (89.1%) were calm on being seen by a resident; 203 (92.3%) said they had the same trust in both. They noted no changes in the tutor when the resident was present (206; 93.6%). They wanted to change the same things in both (kappa=0.518). Patients were satisfied or very satisfied: 212 (96.4%), with the time that the doctor devoted to him/her with the resident present; 194 (88.2%), with having 2 doctors; and 214 (97.3%), with the attention and listening of the resident. Finally, 163 (74.1%) would recommend the resident as a doctor. CONCLUSIONS: Most patients do not know exactly what a FCM resident is or does. They believe that the presence of the resident does not affect the consultation with the tutor. Trust and tolerance is similar. Satisfaction with the care received is high.

Saben nuestros pacientes qué es un residente de medicina de familia? / Do our patients know what a family medicine resident is?

Objetivos. Conocer la percepción que tienen los pacientes del concepto de residente de medicina de familia y comunitaria (MFyC), de su labor y la satisfacción con su trabajo. Diseño. Estudio descriptivo, transversal, mediante cuestionario. Emplazamiento. Centros de salud docentes de MFyC. Área 7. Madrid. Participantes. En total, 220 personas pertenecientes a 21 cupos de tutores. Mediciones principales. Variables sociodemográficas, concepto de residente de MFyC, satisfacción con el residente, comparaciones entre residente y tutor, cambios observados por los pacientes en su médico. Resultados. Había 146 (66,4%) mujeres, con una media de edad de 56,2 ± 18,95 años. El 62,7% (138) no sabe exactamente qué es un residente, aunque el 60% (132) dice que es un médico, el conocimiento aumenta a mayor nivel educativo (p < 0,001) y menor edad (p = 0,04). El 38,6% (85) exige más al tutor y toleran por igual los errores a ambos. El 89,1% (196) está tranquilo cuando le atiende el residente, el 92,3% (203) manifiesta igual confianza. El 93,6% (206) no nota cambios en el tutor cuando está el residente. Desean cambiar los mismos aspectos en ambos (kappa = 0,518). Están satisfechos o muy satisfechos: el 96,4% (212) con el tiempo que el médico le dedica cuando está el residente, el 88,2% (194) por tener 2 médicos, el 97,3% (214) con la atención y escucha del residente. El 74,1% (163) recomendaría al residente como médico. Conclusiones. La mayoría de los pacientes no saben con exactitud lo que es y la labor de un residente de MFyC. Opinan que la presencia del residente no influye en la consulta del tutor. La confianza y la tolerancia son similares. La satisfacción es alta con la atención recibida

Objectives. To find patients' view of the idea of family and community medicine (FCM) residents and of what they do and patients' satisfaction with their work. Design. Cross-sectional, descriptive study using a questionnaire. Setting. FCM teaching health centres. Area 7, Madrid, Spain. Participants. Twenty-one tutors' lists, with 220 people. Main measurements. Social and demographic variables, concept of FCM resident, satisfaction with resident, comparisons between resident and tutor, changes observed by patients in their doctor. Results. Women patients numbered 146 (66.4%); average age, 56.2 (18.95); 138 (62.7%) did not know exactly what a resident was, although 132 (60%) said he/she was a doctor. Knowledge increased with greater educational level (P<.001) and younger age (P=.04). Eighty-five (38.6%) demanded more from the tutor and tolerated errors of both equally; 196 (89.1%) were calm on being seen by a resident; 203 (92.3%) said they had the same trust in both. They noted no changes in the tutor when the resident was present (206; 93.6%). They wanted to change the same things in both (kappa=0.518). Patients were satisfied or very satisfied: 212 (96.4%), with the time that the doctor devoted to him/her with the resident present; 194 (88.2%), with having 2 doctors; and 214 (97.3%), with the attention and listening of the resident. Finally, 163 (74.1%) would recommend the resident as a doctor. Conclusions. Most patients do not know exactly what a FCM resident is or does. They believe that the presence of the resident does not affect the consultation with the tutor. Trust and tolerance is similar. Satisfaction with the care received is high (AU)